Clinical Research Of The RFA Combined With PKP To Treat The Spinal Metastases

Objective Explore the clinical curative effect and safety of the Radiofrequency Ablation(RFA) combined with Percutaneous Kyphoplasty(PKP) to the Spinal Metastases.Methods Operated RFA and PKP on 18 cases of patients with 24 vertebral body, which included 5 cases of Lung Cancer, 3 cases of Breast Cancer, 3 cases of Thyroid Cancer, 2 cases of Prostate Cancer, 2 cases of Kidney Cancer, other parts are 3 cases, the vertebral lesion distribution is: thoracic centrum 16, lumbar centrum 8, all the lesions were dissolve, had lower back pain, no symptoms of spinal cord compression, and valued the clinical curative effect through the preoperational in the first day, first week, first month, second month, third month and the sixth month of Visual Analogue Scales(VAS), Japanese Orthopedic Association Scores(JOA), Rolando-Morris Disability questionnaire(RMDS) and vertebral body height changes in the first day, first week, first month, third month and the sixth month with X-ray and in the third mongth with CT postoperatively. Compared preoperative and postoperative scores and vertebral body height correction all with matching t test.All the difference are statistically significant P<0.05 for the was.Results Only one case(5.6%) had skin burns, all patients without spinal cord, nerve root injury and bone cement leakage. technical success rate is 100%. Pathologic examination before RFA showed that all specimen were bone metastases carcinoma, and no necrosis of tumor cells. Pathologic examination after RFA showed that all bone tumor cells were been necrosis. All cases got completely follow-up 3 months and with an average follow-up 5.2 months. The postoperative pain of all cases relieved apparently within 24 h, Postoperative following 3 months pain relief completely 9 cases(50.0%), 7 cases(38.9%)of medication requirements decreased or painkillers level is reduced, maintain the original amount in 2 case(11.1%) and no one with painkiller's level upgraded. The VAS, JOA, RMDS and vertebral body height preoperational is 8.2, 19.2, 21.3, 2.3cm, 2.6cm, the postoperational is 2.4, 13.3, 26.8, 2.7cm and 2.7cm. Preoperative and postoperative VAS values using matching t test,t1d=2.424, t1w=2.534, t1M=2.341, t2M=2.283, t3M=1.962, t6M=1.923, P were less than 0.05,the difference were statistically significant, it showed that patients with postoperative pain relief significantly.Preoperative and postoperative RMDS values using matching t test, t1d=2.322, t1w=2.231, t1M=2.178, t2M=1.922, t3M=1.931, t6M=1.901, P were less than 0.05, the difference were statistically significant, it showed that patients with daily activities dysfunction improved markedly. Postoperative JOA scores period were greater than 60%,Clinical healing tookgoodeffects.Preoperative and postoperative anterior and trailing edge height value using matching t test,the anterior margin were t1d=2.553, t1w=2.431, t1M=2.378, t2M=2.122, t3M=1.931, t6M=2.190, the trailing edgewere t1d=2.413, t1w=2.451, t1M=2.368, t2M=2.131, t3M=2.021, t6M=1.991, P were less than 0.05, the difference were statistically significant. It showed that the height of the vertebral body got obvious correction.Conclusions RFA combined with PKP, which with minimal injury, is safe and it can restrain the development of the cancer and improve the quality of patients' life significantly in short term.